Asthma

Asthma (from a Greek word which means “panting”) is a chronic airway disorder that is sometimes fatal and can cause significant impairment of daily life. It is characterized by variable and recurring symptoms which are mostly caused by reversible airflow obstruction and bronchospasm.

The explanation for this is simple, the lungs are connected to the outside via bronchi, these are hollow pipelike organs so it isn’t difficult to imagine what will happen if these were to be blocked in any way.Asthma (from a Greek word which means “panting”) is a chronic airway disorder that is sometimes fatal and can cause significant impairment of daily life.

It is characterized by variable and recurring symptoms which are mostly caused by reversible airflow obstruction and bronchospasm. The explanation for this is simple, the lungs are connected to the outside via bronchi, these are hollow pipelike organs so it isn’t difficult to imagine what will happen if these were to be blocked in any way.Asthma can be caused by several factors.

These are usually a combination of complex and incompletely understood environmental and genetic interactions. These factors influence both its severity and its responsiveness to the treatment. It is believed that the recent increased rates of asthma are due to changing epigenetics (heritable factors other than those related to the DNA sequence) and a changing living environment.

So one might argue that the causes of asthma are related to both nature and nurture.Asthma is clinically classified according to the frequency of symptoms, forced expiratory volume in one second (FEV), and peak expiratory rate. These last two are tests that could be carried out in hospitals by spirometry. Asthma may also be classified as atopic (extrinsic) or non-atopic (intrinsic), based on whether symptoms are precipitated by allergens (atopic) or not (non-atopic). While asthma is classified based on severity, at moment there is no clear method for classifying different subgroups of asthma beyond this system.

Finding ways to identify subgroups that respond well to different types of treatments is a current critical goal of asthma research. Some of the signs and symptoms of Asthma are recurrent episodes of wheezing, shortness of breath, chest tightness and coughing. Sputum may be produced in the bronchioles during an asthma attack but is often hard to cough up.

This sputum may appear pus-like due to high levels of white blood cells called eosinophils. Symptoms are usually worse at night and in early mornings or in the response to exercise or cold air. Some people with asthma rarely experience symptoms, usually in response to triggers, whereas others may have marked and persistent symptoms. Associated conditions include a number of other health conditions that occur more frequently in asthmatics.

These include gastro-esophageal reflux disease (GERD) and obstructive sleep apnea. Psychological disorders are also common, with anxiety disorders occurring between 16-52% and mood disorders in 14-41%. However, it is not known if asthma causes psychological problems or if psychological problems lead to asthma. I personally find this statement very funny and I know you do too.

Many environmental factors have been associated with asthma’s development and exacerbation. These include allergens (Any substance that can cause an allergy or a hypersensitivity reaction), air pollution, and other environmental chemicals. It has also been found that smoking during pregnancy and after delivery is associated with greater risk of asthma-like symptoms. Low air quality from factors such as traffic pollution or high ozone levels has been associated with both asthma development and asthma severity. Exposure to indoor volatile organic compounds may be a trigger for asthma; things like formaldehyde exposure, for example, has a positive association.

Asthma is associated with exposure to indoor allergens. Common indoor allergens include: dust mites, cockroaches, animal dander, and mold. Efforts to decrease dust mites have been found to be ineffective so giving your room a good clean every once in a while can help decrease the frequency of attacks. Certain viral respiratory infections such as respiratory syncytial virus and rhinovirus (commonly called common cold, no pun intended) may increase the risk of developing asthma when acquired as young children. Certain other infections, however, may decrease the risk.

Some individuals will have stable asthma for weeks or months and then suddenly develop an episode of acute asthma. Different individuals react to various factors in different ways. Most individuals can develop severe exacerbation from a number of triggering agents. Home factors that can lead to exacerbation of asthma include dust, animal dander (especially cat and dog hair), cockroach allergens and mold. Perfumes are a common cause of acute attacks in women and children.

Both viral and bacterial infections of the upper respiratory tract can worsen the disease. Psychological stress may worsen symptoms-it is thought that stress alters the immune system and thus increases the airway inflammatory response to allergens and irritants.The hygiene hypothesis attempts to explain the increased rates of asthma worldwide as a direct and unintended result of reduced exposure, during childhood, to non-pathogenic bacteria and viruses. It has been proposed that the reduced exposure to bacteria endotoxin in early childhood may prevent the development of asthma, but exposure at an older age may provoke bronchoconstriction.

Bronchoconstriction is when the airways become smaller and this makes the breathing more difficult. Evidence supporting the hygiene hypothesis includes lower rates of asthma on farms and in households with pets.Having a close relative with asthma is a significant risk factor, with many different genes being implicated. If one identical twin is affected, the probability of the other having the disease is approximately 25%. Some genetics variants may only cause asthma when they are combined with specific environmental exposures.There is a correlation between obesity and the risk of asthma with both having increased in recent years in our Gambian society. Several factors may be at play including decreased respiratory function due to a buildup of fat and the fact that the adipose tissue leads to a pro-inflammatory state.

Beta blocker medications such as propranolol can trigger asthma in those who are susceptible. Cardio selective beta blockers, however, appear safe in those with mild or moderate disease. Other medications that can cause problems are NSAIDs (like aspirin, ibuprofen) and angiotensin-converting enzyme inhibitors like captopril.The evidence for the effectiveness of measures to prevent the development of asthma is weak.

Some including: limiting smoke exposure both in utero and after delivery, and breastfeeding. While there is no cure for asthma, symptoms can typically be improved. A specific, customized plan for proactively monitoring and managing symptoms should be created. This plan should include the reduction of exposure to allergens, testing to assess the severity of symptoms, and the usage of medications. The treatment plan should be written down and advise adjustments to treatment according to changes in symptoms.Medications used to treat asthma are divided into two general classes: quick relief medications used to treat acute symptoms; and long-term control medications used to prevent further exacerbation.

Fast-acting· Short-acting beta-adrenoceptor agonists (SABA), such as salbutamol(albuterol USAN) are the first line treatment for asthma treatment. They are recommended before exercise in those with exercise induced symptoms.· Anticholinergic medications, such as ipratropium bromide provide benefit when used in combination with SABA in those with moderate or severe symptoms.Long-term control· Corticosteroids are generally considered the most effective treatment available for long-term control.· Long-acting beta-adrenoceptor agonists (LABA) such as salmeterol and formoterol can improve asthma control, at least in adults, when given in combinations with inhaled corticosteroids.· Leukotriene antagonists may be used in addition to inhaled corticosteroids, typically also in conjunction with LABA· Mast cell stabilizers are another non-preferred alternative to corticosteroids.

Consult your doctor or any heath personnel about a plan of action for acute asthma attacks. Act when your chest feels tight and your reliever inhaler doesn’t help quickly enough. Know when it’s time to grab your bagpack bag and head for hospital – if you wait too long it could cost you your life.